H1N1 Flu Tracked By E-Prescription Data

Public health officials in Rhode Island are electronically monitoring possible swine flu outbreaks based on drug data from pharmacies.

Rhode Island is the first state in the U.S. to begin tracking swine flu outbreaks using e-prescription data.

State public health officials are electronically monitoring possible H1NI outbreaks based on e-prescription data from pharmacies that dispense Tamiflu and three other antiviral drugs used to treat seasonal flu and swine flu.

One hundred percent of the approximately 183 pharmacies in Rhode Island are currently connected into an e-prescription network provided by Surescripts, which along with the pharmacies will be providing public health officials with the flu drug data weekly.

The data will include prescriptions ordered by doctors electronically, or by paper, fax, or phone from independent drugstores as well as those operated by large retail chains such as CVS, Rite Aid, Walgreens, and Stop & Shop.

Public health officials will receive de-identified prescription data along with ZIP codes and ages of patients to aid in the tracking and trending of flu outbreaks through the state. The system uses a computer program that complements another flu tracking system used by state officials. That system includes data from Sentinel, which collects flu data reported by 25 doctor practices located in various geographic regions of the state, and another state system that collects data from hospital emergency departments.

By tracking data from multiple sources, public health officials will get a more comprehensive look at developing trends, such as identifying possible H1N1 outbreaks based on location or patient age, such as clusters of school age children in specific towns.

By using the e-prescription data along with Sentinel and ER data, state health officials can also detect and monitor discrepancies between outbreaks reported by doctors versus outbreaks suggested by the number of flu related drugs being prescribed. The discrepancies could be due to factors such as the over-prescription of flu medicines in absence of actual flu cases, as well as the under-reporting of flu by doctors in a region.

For instance, if state public health officials determine that doctors within a certain zip code are prescribing an usually large number of antiviral medicines in the absence of reported flu cases, state officials could target outreach and educational programs to healthcare providers in those regions.

The system can also give public health officials notice if supplies of Tamiflu and other antiviral medicine are running low, which could trigger the state to release emergency stockpiles.

Thanks to ongoing efforts by a statewide collaborative of healthcare providers, consumers, and leaders from government and academia working to improve healthcare in the state -- Rhode Island is the state with the highest percentage of pharmacies hooked into Surescript's national e-prescribing network, said a Surescript spokesman.

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